Predictive Analysis Of ADC Value On The Efficacy Of Iodine-125 Interventional Therapy For Glioma

Research objectives:Use the advantages of the apparent diffusion coefficient(ADC)quantitative parameter value in preoperative grading evaluation of gliomas to predict their optimal parameters and optimal diagnostic thresholds in the diagnosis of glioma grades The predictive value of ADC value in the curative effect of iodine-125 radioactive particle intervention therapy for glioma.Research methods:1.Recalling 40 cases of glioma diagnosed in surgical pathology at the Affiliated Hospital of Qingdao University from January 2014 to December 2019,this 40 cases were classified as a diagnostic group.The use of ADC values in different grades of gliomas to predict the best ADC value diagnostic parameters and the best diagnostic threshold for gliomas.At the same time,20 cases of glioma patients who were treated with iodine-125 particle intervention therapy were collected.These 20 cases were classified as treatment groups.Analyze the predictive value of ADC value in the therapeutic effect of iodine-125 interventional therapy for glioma.All 60 patients with gliomas underwent magnetic resonance examination and included statistical analysis within two weeks before surgery.2.In the diagnosis group,40 patients with glioma confirmed by surgical pathology were divided into high and low grade groups,of which 13 cases were low grade groups and 27 cases were high grade groups.In the treatment group,20 patients underwent iodine-125 radioactive particle intervention therapy,12 patients underwent total resection before iodine-125 particle interventional therapy,and received adjuvant radiotherapy and chemotherapy.Tumor recurrence was given iodine-125 particle intervention therapy;8 One patient received iodine-125 radioactive particles as the initial treatment due to the location of the lesion at a special site,refusal to undergo surgery,radiotherapy and chemotherapy,and unsuitability for surgical treatment.At the same time,the pathological specimen was obtained and confirmed.The starting point of the 20-patient study was the time of iodine-125 particle intervention,and the end point of the study was the date of death or the date of the last follow-up observation(February 1,2020).3.Statistical analysis: SPSS software(version 18.0,IBM,USA)was used for statistical analysis.The Shapiro-Wilk method was used to test the normality distribution of the parameters of the ADC histogram,and the parameter values that conformed to the normal distribution were expressed as(x±s).The ROC working curve analysis was used to evaluate the diagnostic ability of the ADC histogram parameters for high and low grade gliomas.At the same time,the area under the curve of each parameter value and the optimal diagnostic threshold were calculated.Kaplan-Maier and Log-Rank were used to analyze the overall survival(OS)and progression-free survival(PFS)of patients undergoing iodine-125 particle intervention therapy.Univariate analysis was performed by Cox proportional hazard regression model,all p?0.1 Or variables that are considered clinically meaningful are included in the Cox proportional hazards regression model for multivariate analysis.P?0.05 was considered to be statistically different.Research results:1.Under the same b value,the parameters of ADC histogram are used to evaluate the glioma grading.The smallest ADC value is the most diagnostic value.The best diagnostic threshold is 0.90×10-3 mm2/s.The highest degree.2.Univariate analysis of patients undergoing iodine-125 particle intervention showed that age was an independent factor affecting overall survival and progression-free survival(p = 0.047).The results of multivariate analysis show that age and minimum ADC value are independent influencing factors for overall survival,while only age is an independent influencing factor for progression-free survival.Kaplan-Meier and Log-Rank analysis showed that the median survival time of patients with a minimum ADC value higher than 0.90×10-3 mm2/s was 12 months,and the minimum ADC value was lower than 0.90×10-3 mm2/s.The median survival time of the patients was 6 months,and there was a statistical difference between the two(p = 0.22),while the effect of the minimum ADC level on PFS was not statistically significant.Conclusion:1.The minimum ADC value is the best diagnostic efficiency for glioma grad e evaluation.The minimum ADC value is significantly negatively correlated with t he tumor pathological grade.As the minimum ADC value of the tumor decreases,t he degree of tumor malignancy will increase.2.Patients with a high minimum ADC value(minimum ADC > 0.90×10-3 mm2/s)have a better prognosis and survival after receiving iodine-125 particle inte rvention therapy.